Does Your Immunity Need a Boost?

MADISON, Wis.—Whooping cough is becoming more common in infants – and a big part of the solution is for women to get a booster vaccination before they become pregnant or right after they give birth.

Also known as pertussis, whooping cough is a contagious bacterial disease of the upper respiratory system. It can lead to uncontrollable coughing and breathing difficulties and can cause permanent disability and even death in infants.

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Dr. Jim Conway, an infectious disease specialist and associate professor of pediatrics at the University of Wisconsin School of Medicine and Public Health, says that, until they can be vaccinated, infants are totally dependent on the antibodies they get from their mother during pregnancy.

“The baby’s primary protection for the first couple of months of life is what they get from mom,” Conway says. “So, it is important for moms to get vaccinated, so they can give some immunity to the baby.”

But Conway says this rule doesn’t apply only to the mother.

“Anyone who has contact with infants should also receive the vaccination so that they don’t expose the infant,” he says. “The mother is one part of it, and should receive vaccine either before pregnancy or immediately after delivering. In addition, all family members should get it.”

Dr. Greg DeMuri, also an infectious-disease specialist and associate professor at UW, says there have been greater efforts to get new moms immunized.

“Many women who have given birth have not had a pertussis booster since kindergarten,” he says. “Some hospitals are implementing vaccination programs on their labor and delivery units.”

The booster vaccine not only protects against whooping cough, but also against tetanus and diphtheria. Infants get their first immunizations in three doses, beginning at two months of age. After that first series, children should receive shots between 15 and 18 months; four to six years; and when they reach age 11 or 12.

Immunizations don’t end at childhood, and adults should check with their physicians during routine visits and annual physicals to see if they are due for booster shots to guard against tetanus, an infection often connected to puncture wounds from rusty nails, fish hooks, or open wounds infected by dirt. If left untreated, tetanus may cause muscle contractions and other complications requiring hospitalization.

“Tetanus is a soil microbe, so as long as there is soil, there will be tetanus, and people will be at risk of tetanus contaminating a wound,” says DeMuri. “It’s completely preventable by vaccination. Adolescents and adults should receive regular boosters every 10 years.”

Conway says about 30 to 40 cases are diagnosed annually, and most of them are in the western part of the country and involve people over 40 years old.

“They stop paying attention to their health, think they are super human and don’t need the vaccine,” he says. “Also, it’s not routine practice to administer these vaccines in other countries, and some immigrants may not be protected. Older adults who get tetanus usually survive, but it’s an unpleasant condition in which all of your muscles are spasmodic.”

Conway says people who get puncture wounds or infected lacerations should get a shot as soon as possible if they are not sure of their vaccination history. However, a product called tetanus immunoglobulin can be given to patients who wait too long and put themselves at greater risk.

“If someone stepped on a nail three or four days ago, and they haven’t had a tetanus booster for more than 10 years, tetanus immunoglobulin can provide instant immunity and the antibodies needed to fight off tetanus,” he says.